Citation Nr: 21009586 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 08-38 612 DATE: February 22, 2021 REMANDED Entitlement to service connection for a hip disorder, to include as secondary to service-connected bilateral foot and knee disabilities, is remanded. REASONS FOR REMAND The Veteran served honorably in the United States Army from September 1982 to September 1985. In May 2013, the Board reopened the Veteran’s claims of service connection for low back and hip disabilities and remanded these service connection claims for additional development. In January 2015, the Board again remanded the above claims for additional development. The Board previously denied this claim in an October 2017 Board decision. That decision was subsequently vacated by the Board based on a violation of the Veteran’s due process rights. The Veteran had appointed a new representative who had not been given an opportunity to submit additional evidence or argument prior to the Board’s promulgation of the October 2017 Board decision. In June 2019, after the Veteran’s new representative had submitted additional evidence and argument in support of his claims, the Board remanded the Veteran’s claims of service connection for back and hip disabilities to obtain updated treatment records and VA medical examinations and opinions. Specifically, the Board asked for a VA medical examiner to consider whether the Veteran’s back and hip disabilities were secondary to service-connected disabilities. In a September 2020 rating decision, the Veteran was granted service connection for his low back disability. As this is a full grant of the benefits sought on appeal, this claim is no longer on appeal. Cf. AB v. Brown, 6 Vet. App. 35 (1993). Regarding the Veteran’s claim of service connection for a hip disability, remand is again necessary to ensure the Veteran all due process. Entitlement to service connection for a hip disorder, to include as secondary to service-connected bilateral foot and knee disabilities, is remanded. The Veteran contends that his current hip disorder was either incurred during service or is secondary to his service-connected disabilities to include bilateral foot and knee disabilities. Service connection may be established on a secondary basis for a disability that is proximately due to, or the result of a service-connected disease or injury. 38 C.F.R. § 3.310 (a). Establishing service connection on a secondary basis requires evidence sufficient to show that a current disability exists and that the current disability was either caused by or aggravated by a service-connected disability. 38 C.F.R. § 3.310 (a) (2019); Allen v. Brown, 7 Vet. App. 439 (1995). The June 2019 remand requested that a VA examiner provide a medical opinion as to whether the Veteran’s hip disorder is at least as likely as not caused by or aggravated beyond its natural progression by his service-connected disabilities. In January 2020, a VA examiner opined that the Veteran’s hip disorder was not related to service and was not related to his hip, back, or knee conditions. The VA examiner did not provide any opinion regarding aggravation. In August 2020, the VA examiner was asked for an addendum opinion and stated that the Veteran’s hip discomfort began after his back, foot, and knee issues. The Board finds that this statement is non-responsive to the question of whether the Veteran’s hip disorder was aggravated by his service-connected conditions. In September 2020, the VA examiner was again asked for an addendum opinion. The VA examiner opined that the Veteran’s hip disorder was not incurred during service. Regrettably, none of the VA medical opinions from January 2020, August 2020, and September 2020 address whether the Veteran’s hip disorder was aggravated by his service-connected disabilities. Causation and aggravation are independent concepts and should have separate findings and rationales. Atencio v. O’Rourke, 30 Vet. App. 74 (2018). An opinion to the effect that one disability “is not caused by or a result of” another disability does not answer the question of aggravation. El-Amin v. Shinseki, 26 Vet. App. 136, 140-41 (2013). The Board finds that a new VA medical opinion is necessary to determine whether the Veteran’s hip disorder was caused by or aggravated by the Veteran’s service-connected disabilities. As the Veteran has been found entitled to service connection for his low back disability, lumbosacral strain, the VA examiner should also consider whether this condition caused or aggravated the Veteran’s hip disorder. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s hip disorder is at least as likely as not proximately due to his service-connected disabilities, or was aggravated beyond its natural progression by service-connected disabilities, to include service-connected back, bilateral foot, and bilateral knee disabilities. (a.) The VA examiner must provide separate findings and rationales relating to causation and aggravation. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Casey, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.